MENG-CHEN WULI-KAI TSAIWu C.-C.SHIN-JOE YEHSUNG-CHUN TANGChen Y.-J.Chen C.-L.JIANN-SHING JENG2021-12-222021-12-22201410523057https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901381330&doi=10.1016%2fj.jstrokecerebrovasdis.2013.09.015&partnerID=40&md5=9e87ae24ef8970906727076450d9b133https://scholars.lib.ntu.edu.tw/handle/123456789/590504Large anterior choroidal artery (AChA) infarcts are frequently associated with stroke evolution. This study aimed to investigate the major determinants for stroke evolution in patients with large AChA infarcts. Methods: We studied 118 consecutive adult patients with acute large AChA infarcts. The diagnosis was confirmed as abnormal hyperintensities in 3 or more rostracaudal magnetic resonance imaging slices (5 mm thickness) using diffusion-weighted imaging within typical AChA vascular regions. Stroke evolution was defined as neurologic deterioration with an increase in National Institutes of Health Stroke Scale (NIHSS) score by at least 4 or an increase of NIHSS score in motor function by at least 2 in 7 days after stroke onset. Results: Forty-seven (39.8%) patients developed stroke evolution. Thrombolytic therapy was inversely associated with the occurrence of stroke evolution (P =.004). Using multivariate analysis, thrombolytic therapy was the only protective determinant for stroke evolution (adjusted odds ratio,.08; 95% confidence interval,.01 to.67). Patients with large AChA infarcts receiving thrombolytic therapy had less unfavorable long-term functional outcome than those not receiving thrombolytic therapy (adjusted odds ratio,.11; 95% confidence interval,.02-.75). Conclusions: Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome. ? 2014 by National Stroke Association.[SDGs]SDG3alteplase; adult; aged; article; brain infarction; cerebrovascular accident; deterioration; diffusion weighted imaging; female; fibrinolytic therapy; human; large anterior choroidal artery infarct; major clinical study; male; motor performance; National Institutes of Health Stroke Scale; nuclear magnetic resonance imaging; priority journal; risk reduction; treatment outcome; Cerebral Infarction; chi square distribution; disability; disease course; middle aged; motor activity; multivariate analysis; neurologic examination; pathophysiology; predictive value; retrospective study; risk; risk factor; statistical model; Aged; Cerebral Infarction; Chi-Square Distribution; Diffusion Magnetic Resonance Imaging; Disability Evaluation; Disease Progression; Female; Humans; Logistic Models; Male; Middle Aged; Motor Activity; Multivariate Analysis; Neurologic Examination; Odds Ratio; Predictive Value of Tests; Retrospective Studies; Risk Factors; Thrombolytic Therapy; Treatment Outcomejournal article10.1016/j.jstrokecerebrovasdis.2013.09.015241352342-s2.0-84901381330